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Description: Heart Attack (Myocardial Infarction) by Rosalyn Carson-DeWitt, MD Definition A heart attack occurs when blood flow to the heart muscle is interrupted. This deprives the heart muscle of oxygen, causing tissue damage or tissue death.

Causes A heart attack may be caused by:

Accumulation of fatty plaques in the coronary arteries Development of a blood clot in the coronary arteries Narrowing of the coronary arteries Spasm of the coronary arteries Thickening of the walls of the arteries feeding the heart muscle (coronary arteries) Risk Factors A risk factor is something that increases your chance of getting a disease or condition.

Diabetes Family members with heart disease High blood cholesterol (specifically, high LDL... More

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Heart Attack (Myocardial Infarction) by Rosalyn Carson-DeWitt, MD Definition A heart attack occurs when blood flow to the heart muscle is interrupted. This deprives the heart muscle of oxygen, causing tissue damage or tissue death.

Causes A heart attack may be caused by:

Accumulation of fatty plaques in the coronary arteries Development of a blood clot in the coronary arteries Narrowing of the coronary arteries Spasm of the coronary arteries Thickening of the walls of the arteries feeding the heart muscle (coronary arteries) Risk Factors A risk factor is something that increases your chance of getting a disease or condition.

Diabetes Family members with heart disease High blood cholesterol (specifically, high LDL cholesterol, and low HDL cholesterol) High blood pressure High blood triglycerides Increased age Obesity Sedentary lifestyle Sex: Male Smoking Stress Symptoms Symptoms include:

Loss of consciousness Nausea Pain in the left shoulder, left arm, or jaw Shortness of breath Squeezing, heavy chest pain, especially with: A large meal Cold weather Emotional stress Exercise or exertion Sweating, clammy skin Weakness Unusual symptoms of heart attack (may occur more frequently in women):

Back pain Confusion Fainting Stomach pain Diagnosis If you think you are having a heart attack, call 911 immediately. You need emergency medical care.

Tests may include:

Blood Tests – to look for certain substances found in the blood within hours or days after a heart attack. Blood tests will be repeated every 6-8 hours to track the progressive elevation of certain enzymes that indicate heart muscle damage.

Urine Tests – to look for certain substances found in the urine within hours or days after a heart attack

Electrocardiogram (EKG) – records the heart's activity by measuring electrical currents through the heart muscle. Certain abnormalities in the EKG occur when there is significant blockage of the coronary arteries and/or damage to the heart muscle. The EKG will be repeated to track the progression of these changes.

Echocardiogram – uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart

Stress Test – records the heart's electrical activity under increased physical demand

Thallium Stress Test – thallium is used to scan the myocardium, the middle layer of the heart

Nuclear Scanning – radioactive material is injected into a vein and observed as it is absorbed by the heart muscle

Electron-beam CT scan – a type of x-ray that uses a computer to make pictures of the heart and surrounding structures

Coronary Angiography – x-rays taken after a dye is injected into the arteries; to look for abnormalities in the arteries

Treatment Treatment may include:

Anti-anxiety medications Atropine Beta-blocking and/or ACE inhibitor medications Clot-busting agents: within the first six hours after a heart attack, you may be given medications to break up blood clots in the coronary arteries. These include: APSAC Streptokinase Tissue plasminogen activator (tPA) Nitrate medications Oxygen Pain-killing medications (such as morphine) Surgery Surgeries for people with severe blockages in their coronary arteries may include:

Atherectomy Balloon angioplasty with or without stenting Coronary bypass graft Physical or Rehabilitative Therapy During recovery from a heart attack, you may need physical or rehabilitative therapy to help you regain your strength.

Psychotherapy or Antidepressant Medication Some people have depression after suffering a heart attack. If you do, psychotherapy and/or antidepressant medications may help relieve depression.

Prevention Preventing or treating coronary artery disease may help prevent a heart attack.

Appropriately treat high blood pressure and/or diabetes. Ask your doctor about taking a small, daily dose of aspirin. It has been shown to decrease the risk of heart attack. Ask your doctor about taking cholesterol-lowering medications. Ask your doctor about taking medication to improve heart function or prevent future ehart attacks, such as: ACE-inhibitors Beta-blockers Digitalis-type drugs Platelet inhibiting drugs Ask your doctor about taking nitrate medications if you have angina due to coronary artery disease. Begin a safe exercise program with the advice of your doctor. Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables. If you smoke, quit. Maintain a healthy weight. Last reviewed: January 2004 by Rhonda Kaufman, MD.

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